Let’s talk about something that doesn’t get enough attention: peeing when you cough after having a baby.
You may have wondered, “Why do I pee when I cough?” before but then accepted it as part of the “mom life” package. But the truth is that it doesn’t have to be.
Sure, our culture loves to crack jokes about moms and their “oops” moments. But just because something is common, you don’t have to accept it as your new normal.
As a Pelvic Floor Physical Therapist, I’ve helped hundreds of women stop leaking when they cough, sneeze, run, and jump so they can go back to living an active life worry-free.
In this article, I’ll explain why stress urinary incontinence (the fancy word for leaking pee) happens and, more importantly, what you can do about it!
Postpartum urinary incontinence is when you leak a little (or a lot) of pee when you’re not planning to.
You might experience this when you:
Basically, any activity that puts pressure on your abdomen can trigger leaking urine.
It’s very common, and 1 in 3 women who have had a baby may experience it at some point.
Your pelvic floor muscles support your bladder, uterus, and bowels.
During pregnancy and childbirth, these muscles go through big changes and, in some cases, get weaker.
A lot of the time, the pelvic floor also loses its coordination with the brain.
And during vaginal delivery, the pelvic floor musculature is stretched to 250% of its resting length during delivery.
The fact that your body can do that is incredibly impressive, but it also means that your pelvic floor muscles may not provide the same level of support they did before pregnancy.
Your core muscles also often get weaker in pregnancy, which puts an additional strain on your pelvic floor. Pelvic floor weakness, combined with a weaker core, makes it harder for you to control your bladder.
Hormonal changes can also contribute to urine leaks. You might notice more urge incontinence:
Try these postpartum pelvic floor exercises to improve your pelvic floor health.
It varies for every mama. Some women might experience leaks only for a few weeks, but many others might deal with it for months or even years – especially if left untreated.
One study showed that in the 3 months postpartum, 34.3% of women had urinary incontinence, of which 8.5% needed to wear pads. But in my experience as a Pelvic Floor Physical Therapist, these numbers are much higher.
The good news is that you’re not stuck with bladder leaks forever. With the right care and exercises, many women see improvements in just a few weeks.
Your body is amazing and resilient, and it’s possible to treat stress incontinence even if you’re been dealing with it for years.
Peeing when you cough is common, but it doesn’t have to be your normal!
I know it might feel like every mom you know is dealing with this, but you CAN live a completely leak-free life! Yes, even after having babies!
Don’t accept peeing while coughing as just another “mom thing.” Don’t shrug it off as a “requirement of motherhood.”
It breaks my heart to see how our society has normalized pelvic floor issues. We see it in movies, TV shows, and even in those “relatable” mom memes. But just because something is common doesn’t mean it’s okay or that you have to live with it.
You deserve to run, jump, laugh, and sneeze without fear of leaking. You deserve to play with your kids on the trampoline without worrying about embarrassing moments. You deserve to feel confident in your body and its abilities, and, with the right support, it’s very much possible.
Before we dive deeper into long-term stress incontinence treatments, here are some quick tips to keep you dry when a sneeze or cough catches you off guard.
Check out this video on my Instagram where I demonstrate these tips!
The tips above are great for those “uh-oh” moments, but you don’t have to rely on them for the rest of your life. There’s a better long-term solution.
The key to conquering postpartum urinary incontinence is strengthening your core and pelvic floor muscles to manage the intra-abdominal pressure with coughs, sneezes, jumps, running, and more.
One way you can do this is to work with a Pelvic Floor Physical Therapist. They can assess your specific needs and create a personalized pelvic floor therapy plan for more bladder control.
But for many moms, seeing a PT means having to find childcare and driving – not to mention a high cost.
This is why I created Strong Core Mama – it’s a physical therapy program for postpartum moms that you can do completely online and still reap the benefits!
It’s the perfect fit for moms who want to:
Learn more about Strong Core Mama + join today!
Many moms think the key to a strong pelvic floor is to keep it tight and contracted all the time. But that’s actually counterproductive!
Your pelvic floor muscles need to be able to both contract AND relax to do their job.
If you’re doing an exercise, such as a bicep curl or a squat, you wouldn’t just keep your muscles engaged all day long. You’d need to come back to a resting position at some point.
Your pelvic floor is a group of muscles, and it works the same way.
If you’re constantly tensing your pelvic floor, it’s like asking your muscles to hold a weight up 24/7. They get tired, overworked, and weaker over time.
A healthy pelvic floor is a flexible pelvic floor. It should be able to contract when you need it (like when you cough or lift something heavy) and relax when you don’t.
In my experience as a Pelvic Floor PT, I’ve seen many moms who complain that they can stay leak-free with the first sneeze or for the first day of coughing, but then start leaking on day two.
This happens because the pelvic floor muscles get *really* tired of being “always on,” so it’s essential to learn how to “reset” your pelvic floor.
I teach you how to contract/relax your pelvic floor correctly in Strong Core Mama!
After pregnancy and birth, your pelvic floor muscles have been through a lot and are probably weakened. These muscles play a crucial role in supporting your bladder, so if they’re not working properly, it’s harder to “hold it in,” especially when there’s sudden pressure from coughing or sneezing.
Not being able to hold your pee after having a baby is a very common problem, but it doesn’t mean that you have to accept it as an inevitable part of motherhood. With the right postpartum pelvic floor rehab, you can become leak-free.
While it’s common, it’s not something you should consider “normal” or accept as your new reality. 1 in 3 women who have had a baby may experience leaking at some point. Our culture often normalizes this through jokes and media portrayals, but it’s important to know that it’s treatable with physical therapy.
There’s no direct link between epidurals and long-term urinary incontinence. Postpartum incontinence is more related to the physical changes of pregnancy and childbirth itself. It doesn’t have much to do with the pain management methods used during delivery.
Leaking can sometimes improve on its own in early postpartum, but not always. If you’re past the first few weeks of postpartum and still leaking, then it most likely won’t go away on its own. That said, in many cases, stress incontinence can improve or even completely resolve with proper treatment. Physical therapy that focuses on pelvic floor muscles and core can give you significant improvements.
The key is to be proactive and seek support!
Ignoring stress incontinence won’t make it disappear. If left untreated, it can persist or even worsen over time. In my experience as a Pelvic Floor PT, I’ve also seen it get worse in perimenopause with the hormonal changes.
Leaking may make you want to avoid activities you love, such as playing with your kids or exercising. It can also impact your intimate relationships and overall quality of life. Women often feel that they can only wear certain types of clothing – such as black leggings – when they actually want to wear shorts or colored items. That’s why it’s so important to address leaking early and not just accept it as part of motherhood!
Coughing itself doesn’t damage your pelvic floor. But forceful coughing (like during a bad cold) can put extra stress on the already weakened pelvic floor muscles, potentially making leaking worse.
The goal isn’t to stop coughing! It’s a natural and necessary bodily function. Instead, focus on strengthening your pelvic floor so it can better handle the pressure from coughs and sneezes.
To properly tighten the pelvic floor, you have to be able to relax the pelvic floor. This is a common misconception I often see as a Pelvic Floor Physical Therapist. The truth is that many women aren’t relaxing their pelvic muscles enough so they get “tired” and contribute to more leaks.
It’s important to strengthen muscles, but you also need to learn how to relax them for your pelvic floor to properly contract. The pelvic floor exercises I share in Strong Core Mama teach you how to strengthen your pelvic floor AND keep it relaxed.
The exercise I see recommended most often is Kegel exercises, and while they can be effective when done correctly, a comprehensive approach is best. To stop leaking postpartum, you need exercises that target your deep core muscles, proper breathing, pelvic floor muscles, and more.
Doing just one type of exercise isn’t going to fix urinary incontinence after birth! The important thing is to progress the exercises and not just stick with the same ones. I’ve seen many moms who do the same 3 exercises religiously and notice no change, and the reason for that is not progressing the exercises. I teach you the right, evidence-based way in my program Strong Core Mama!
Every mama’s journey is different, but many women start to see improvements in their pelvic floor strength within 6-8 weeks. The important thing is to be patient with yourself and stay consistent. The exercises to heal and strengthen your pelvic floor muscles don’t have to take a ton of your time. 15-20 minutes, 2-3x/week is perfect!
Mamas who’ve had C-sections can experience stress incontinence the same way as mamas who gave vaginal birth. It’s common, but you don’t have to accept it as your “normal.” Pregnancy and the C-section impact your pelvic floor and core muscles, which makes it harder for you to control your bladder.
In my program Strong Core Mama, I have an additional C-section track that addresses pelvic floor concerns related to a Cesarean delivery!
If you’re ready to live leak-free, Strong Core Mama is a targeted, evidence-based physical therapy program for moms in all seasons of life. It’s designed for mamas anytime post delivery, whether that’s 6 months or 6+ years.
The education and exercises I share are developed based on actual experiences with hundreds of mama patients in the physical therapy clinic. The difference is that you can do the program on your own terms + completely online!
Plus, I’m there to answer questions and provide support. Learn more about Strong Core Mama!